Presumptive Transfer Requirements
Services provided by Merced County Behavioral Health and Recovery Services (BHRS)
BHRS provides Specialty Mental Health Services which include services to youth that meet criteria for Severely Mentally Ill criteria or Severely Emotionally Disturbed. Services may include Individual Therapy, Intensive Home-Based Services (IHBS), Intensive Care Coordination (ICC) and Case Management.
Mild to moderate services are provided by a primary care provider (PCP) or the Managed Care Program. Merced County’s Managed Care Program Provider for mild to moderate services is Beacon. Please click on the Beacon link to access the website. To log in please enter Plan Name CCAH.
The following applies to AB1299 presumptive transfer youth when it is assumed that youth will be placed in a long term placement.
The placing agency/Mental Health Plan (MHP) should send information about the presumptive transfer to Merced County within 3-business days of the decision by fax, mail, or email.
Please ensure that the foster child’s residence address is updated in the Medi-Cal Eligibility Data System (MEDS) reflecting Merced County address within 2-business days of making the determination.
The notification from Placing County shall be sent to Merced County within 3 business days and shall include:
- Identifying information about the child: name, date of birth, and address;
- Name, location, and contact information of the referring placing agency;
- Send or arrange to have sent to Merced County the most recent court document to identify the legal holder of privilege such as Order After Hearing-indicates dependency/Detention Report/Jurisdiction Disposition Report (Juris-Dispo). Indicate on the NOTIFICATION if the court/legal documentation will be sent and include the date for submittal to Merced County BHRS.
- Name and contact information of who can sign releases of information;
- Name and contact information of who can sign consents;
- Send, or arrange to have sent to Merced County the most recent consent for services, and consent for medication, including the JV-220. Indicate on the NOTIFICATION if the court/legal documentation will be sent and include the date for submittal to Merced County BHRS.
Send, or arrange to have sent to, the Merced County the most recent mental health records, including the most recent mental health assessment.
- Merced County BHRS must have all consents signed by the court-appointed legal authority. Please complete the Consent Form packet and submit to Merced County Managed Care. Indicate on the NOTIFICATION if the court/legal documentation will be sent and include the date for submittal to Merced County BHRS. Please note that the following consents are required to be returned to Merced County BHRS via fax, mail or encrypted email sent to firstname.lastname@example.org:
- Merced County Behavioral Health & Recovery Services Authorization for Release of Information
- Authorization for Treatment of a Minor (This form is written in Spanish/English languages)
- Acknowledgment of Receipt of Notice of Privacy Practices (Notice of Privacy Practices)
- Merced County Behavioral Health & Recovery Services Assignment of Benefits
Waivered AB1299 Presumptive Transfer
- If a youth does not meet AB1299 presumptive transfer requirements or it is not clear the youth meets AB1299 presumptive transfer requirements, please submit an authorized Service Authorization Request (SB785) by placing county/MHP, in order to start services immediately.
- We must have Merced County Consent signed by the court-appointed legal authority. Please complete the Consent Form packet and submit to Merced County Managed Care.
Merced County Social Workers / Merced County Probation
Merced County Social Workers and/or Merced County Probation personnel completing a Presumptive Transfer for Merced County Dependents should complete the following forms:
- Authorization for Release of Information
- Notice of Transfer
- Identify who has legal privilege/consent
- Indicate County receiving youth and contact information to send mental health correspondence to
- Return forms to Behavioral Health and Recovery Services
- Email: email@example.com
- Fax: (209) 724-4046 ATTN: BHRS PT Designee(s)
- Mail: P.O. Box 2087, Merced, CA 95344 ATTN: Quality Improvement
The following applies to Merced County youth that does not meet the criteria for AB1299 Presumptive Transfer:
- If requesting Mental Health Services for youth placed out of county please submit SAR to Liliana Pulido, LCSW, and Leticia Servin, LMFT. Ensure the authorized Medi-Cal Codes for Adoption Assistance Program (APP) and/or Kinship Guardian Assistance Program (Kin-GAP) are established.
- A completed SAR request can be faxed to (209) 724-4046 or sent within an encrypted email to firstname.lastname@example.org
- Please indicate on Subject Header: SAR Request
- If you need assistance please reference SW Guide on Requesting Managed Care Authorization for Merced youth.